ashleyalp | Medical Futures Lab

Apr 26 2014

Design, Electronic Medical Record, Medicine, Technology

The Importance of Usability: Putting the Patient First

In addition to developing apps that allow patients to track their lifestyle habits—exercise, diet, sleep patterns, etc—mHealth is also promising in its potential to engage patients in their general health information. Specifically, in the information that is stored in hospital health records. A play on EHRs, Mana Health has developed “a patient portal solution that has been designed for today’s consumer.”

Mana Health is a New York startup that won the opportunity to design the patient portal for the New York eHealth Collaborative, a non-profit organization that works to improve health care for New Yorkers through the development and establishment of electronic health records. Mana Health recently designed an interface that facilitates the sharing of patient data around the state, not only between hospitals, but also from hospital-to-patient. The endeavor is unique because it is not contained in a single healthcare system, but rather will pull information from across the state and consolidate it in a user-friendly “patient portal” platform.

One of the best features of the program, at least in my opinion, is how user-friendly the interface appears to be. While existing electronic medical records (such as Epic) are filled with numbers and abbreviations, Mana Health’s platform is truly geared towards the patient and offers streamlined graphics that illustrate the patient’s relevant health information.

Screen Shot 2014-04-26 at 11.08.35 PM

Mana Health’s platform transforms the complex electronic health record into a personal health record that allows patients easy access to their information: “unlike the clunky PHRs of days past, they said they wanted something that a typical consumer would feel comfortable using.” Their concern for user-centered designs is something that all mHealth developers should strive to emulate. The liberal use of color-coded graphics is a simple way to increase the scope of users, especially to those who may have low health literacy and will serve to benefit from the image-based layout.

As mHealth advances, there are many issues that will continue to spring up. I have addressed several of these in past blog posts—addressing low health literacy, accessing hard-to-reach populations, funding mHealth endeavors—and the creation of user-friendly platforms is yet another point of serious consideration. mHealth is a direct product of creativity and innovation, and these driving forces should not stop at the development of the idea, but carry over into the details of its execution.

http://www.mhealthnews.com/news/new-patient-portals-bring-mobility-hix?page=0

http://mana-health.com

http://nyehealth.org/about-nyec/

Apr 25 2014

Design

mHealth to Improve Health Outcomes: Paying the Bill

As we continue to develop innovations in mobile health technology, one of the first questions that needs to be asked is “Who’s paying for this?” Effective mHealth campaigns should be tailored to their target audience, which requires preliminary research about the platform and its potential, conducting focus groups, and multiple rounds of pilot testing.This costs money, and most industries want to see profits in a timely manner. In answer to the growing interest in mobile health, the National Institutes of Health (NIH) has developed two grants to fund mobile health aspirations. Specifically, these grants are aimed at “utilizing mobile health tools aimed at the improvement of effective patient-provider communication, adherence to treatment and self-management of chronic diseases in underserved populations.”

The article I read, which outlined the NIH’s plans entitled “NIH grants to fuel adherence, patient-provider communication” initially caught my attention due to its direct alignment with the interests of my MMAL group: patient adherence and patient-doctor communication. In order for patients to adhere to their treatment plans, it is important for them to feel engaged in their health. The NIH notes the potential of mobile health to “educate patients about the importance of sticking with treatment regimens and changing behaviors,” a promising avenue to improving adherence.

These grants simultaneously address the need for increasing mobile health use and the importance of patient-doctor communication to foster patient adherence and better health outcomes. However, what makes these grants stand out to me as relevant is their direct address of “underserved populations.” It is all too easy to overlook the destitute when visualizing shiny new mobile health technology innovations. However, these populations suffer the worst health disparities, especially for chronic health conditions and could stand to benefit (possibly the most) from mobile health innovations. In its quest to serve all populations, the NIH also addresses one way in which they plan to avoid using mHealth to marginalize other populations. Specifically, they hope “to transmit patient data digitally from remote areas to specialists in urban areas,” taking advantage of the growing wireless infrastructure available to the population.

Finally, the projects funded by these grants should be designed to last two years, with costs not exceeding $275,000.

It is my hope that medical professionals will take this opportunity to address health disparities in their communities in a creative and innovative way. mHealth holds a growing potential to improve health conditions among those populations most strife with health disparities. Increasing patient adherence by using technology to foster patient-doctor communication will certainly prove effective in the very near future.

Apr 25 2014

Communication, e-patient, Health, Medicine, Technology

Promoting Patient-Centric Adherence: Emerging mHealth Technologies

Last night we had our final Medical Media Arts Lab presentations—a bittersweet culmination of all of the hard work we as a class have put forth throughout the semester. My group finally had the opportunity to present a detailed plan and accompanying visuals detailing our mobile app solution for improving patient-doctor communication regarding shared treatment plans for Type II diabetics. Professionals in the audience gave us some very valuable feedback and suggestions, which, should the project continue, would greatly improve our existing design and the user experience. Our app focuses on improving patient adherence by creating shared treatment plans that take both the patient and doctor’s needs into consideration. To enhance our design, it was suggested that we add a reward component that provides positive feedback to patients who follow their treatment plans, as well as include an avenue for patients to socialize in an effort to increase motivation and accountability. I assumed that these were components our team would need to develop; however, it turns out that mHealth startups have already started to explore these possibilities, both within the context of diabetes, and for chronic and other health conditions in general.

I came across these emerging businesses on the mHealth News website, outlined in an article entitled “Startups bolster adherence via social networking, mobile apps.” Ayogo and Get Real Health “offer a care coordination platform and mobile application, respectively, that seek to improve on…abysmal adherence statistics.” I was particularly interested in Ayogo, which utilizes a health behavior change and gamification platform called GoodLife to establish meaningful social interactions between patients, patients and their family members, and patients and their doctors around their health condition.

The platform also utilizes psychological triggers and secondary applications to personalize the user experience. The specific mobile app used by Ayogo is called Empower, which “helps patients who are newly diagnosed with a chronic condition to take control of their treatment.” The app organizes the patient’s treatment plan into a ‘health habit curriculum’ that uses behavior change principles, self-reporting, social interactions, and a rewards system to encourage adherent patient behavior.

The app tries not only to engage patients in their prescribed treatment plans, but also to actually establish new habits in the patient’s daily life by having them complete small activities or games each day that both facilitate the patient-reward system, but also help the program tailor to the patients’ needs. By actively engaging patients with the app through games, rewards, and social features, Empower, and more broadly Ayogo, helps patients improve adherence to their treatment plans.

It seems that the only missing component is the facilitation of real-time patient-doctor communication about the treatment plan. This app offers what to me seems like a brilliant, innovative proposal to a problem common across nearly all chronic health conditions; however, our development offers that extra, crucial component addressing the in-person patient-doctor encounter. As we move forward, app developers should remain open to learning and growing from the work of other startups. Mobile health is a rapidly growing field that offers much opportunity for profit and competition. However, let us not lose sight of the key stakeholder—the patient. As the race for the next innovation commences, we need to make sure that all possibilities are considered, collaboration is encouraged, and innovation is allowed to reach its full potential.

http://www.mhealthnews.com/news/startups-bolster-adherence-social-networking-mobile-apps

http://ayogo.com/index.html

Apr 23 2014

2 Comments

Health, Medicine, Technology

Increasing the Scope of mHealth: Telemedicine Behind Bars

In designing mHealth solutions, one of the most important initial steps is identifying the target population. Asking “Who will benefit?” is one of the best ways to kick-off a successful, targeted mHealth campaign. To do this, we spend time gathering statistics about how many people own mobile phones, who owns smartphones, who texts, who tweets, and who talks. As we narrow down our target population to a specific subset, certain groups will inevitably be left out. One such population, is the incarcerated.

While inmates are not generally allowed access to mobile phones, mobile health, specifically telemedicine, holds a lot of promise in improving healthcare among this population. In December 2013, mHealth News reported that the Louisiana Department of Corrections (DOC) was planning to increase the use of telemedicine in their prisons three-fold as the primary healthcare delivery system for its inmates. By collaborating with AMD Global Telemedicine Inc—the leading Telemedicine Encounter Management Solutions supplier—the DOC hopes to serve over 50,000 inmates. Prior to this innovation, handcuffed prisoners had to be transported 150 miles by bus to reach the nearest healthcare facility, where all prisoners had to remain until everyone had been seen.

By establishing a telemedicine infrastructure—training doctors and healthcare professionals and purchasing video and medical equipment—inmates can be screened for the few that need face-to-face interaction, while the others can be seen virtually from the prison. With the technology provided by AMD, up to 15 patients can be seen by a single physician in just four hours. In addition to increasing productivity and tailoring care, the increased use of telemedicine is also cost-effective. Using telemedicine will greatly reduce transportation costs and payment for personnel who need to be transported from the prison. Additionally, the DOC is receiving additional funding from the state, which will allow it to pay for the aforementioned training and purchases.

Telemedicine is also especially valuable because it provides an opportunity for the consolidation of medical information through the digital interface. An article in PRWEb covering this telehealth development describes the program’s capacity to “deliver live medical images from connected medical devices and scopes, real-time video from an examination camera, and the ability to view patient documents and vital signs data all in the same online platform.” Furthermore, patients can use telemedicine to access physicians of 16 different medical specialties, including primary care, neurology, and endocrinology.

Telemedicine provides a very promising avenue for using media and digital technology to reach underserved populations. The incarcerated community is oftentimes overlooked for many medical innovations. However, this is one valuable opportunity in which such innovations can, and most likely will, be both highly useful and significantly impactful. While it is simple enough to design media solutions for educated professionals, the potential of mHealth is much more expansive, and should be utilized in as many ways as possible.

http://www.mhealthnews.com/news/telemedicine-behind-bars-prison-mobile-mHealth?page=0

http://www.prweb.com/releases/2014/02/prweb11575342.htm

Apr 06 2014

Communication, e-patient, Health, Technology

Mindful mHealth

In the past several years, there has been increased discussion about bringing medicine into the technological era, and out of the darkness of paper methods and inefficiency. Words and phrases like “media,” “digital,” and “mobile technologies”are becoming more and more linked to healthcare. Because we do live in the age of technology, a time when nearly every person in America owns a cell phone (91%) and uses the internet, such a movement seems not only favorable, but necessary. As we push medicine into the digital age, we applaud new, innovative uses of advanced technology for testing, treating, and tracking—for features that allow the new age of “ePatients” to take control of their health.

One of the most “fashionable” new technologies is the mobile app. Apps allow patients to use their mobile phones to track their diet, exercise, blood pressure, etc. With so many emerging uses, smartphones provide a promising avenue to increased ePatient activity. As a result, when people think of patient-centered health media, the first thing that comes to mind is generally mobile apps—or is it?

When I say “people,” this is a very biased demographic. I am a Rice University student in a Medical Media Arts class. While my peers come from very diverse backgrounds, our current lifestyle places us in a specific demographic—that of educated young people who are exposed to mobile technology, specifically smartphones, on a daily basis. Those developing mobile health technologies generally come from similar backgrounds, in that they are most likely very familiar with smartphone usage, and quite possibly own smartphones themselves. For a significant portion of the population, this is not the case.

According to Pew Research, only 58% of Americans own a smartphone. While this is more than half of the population, this still means that roughly 131.8 million Americans (42%) do not own a smartphone or have access to mobile applications.

One of the many advantages of mobile technology is its ubiquitous nature and its potential to bridge health disparities by reaching large, diverse populations. However, if all of our focus is placed in a sector of mHealth that such a significant portion of people do not have access to, we are only compounding health disparities with a technological one.

While I believe that mobile applications are a very promising avenue of healthcare, I think that other mobile phone capabilities should continue to be utilized. For example, while only 50% of cell phone owners download mobile apps, 81% send and receive text messages. Text messaging is a simple, low-cost technology, which can be utilized with or without a smartphone, and has consistently been in greater use than mobile apps.

While text message-use is beginning to level-out, mobile app usage is still increasing. However, until the transferral to mobile apps is complete, the “non-app” population should not be ignored. Text message-based mHealth campaigns have already been developed, such as Txt4health, SmokefreeTXT, and text4baby. All of these services promote positive health behaviors by sending text message reminders to patients in the program. We should use these programs as models while we consider avenues that promote patient-centered healthcare and patient engagement, and be mindful of who we are trying to reach and how to best reach them. While mobile applications are a promising platform, which should definitely be utilized, we also have to ensure that we make mobile technologies the solution and not the problem in addressing health disparities.

Medical Futures Lab

Author Archives: ashleyalp

The Importance of Usability: Putting the Patient First

mHealth to Improve Health Outcomes: Paying the Bill

Promoting Patient-Centric Adherence: Emerging mHealth Technologies

Increasing the Scope of mHealth: Telemedicine Behind Bars

Mindful mHealth

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